Spinal fusion

If you are paying for your own treatment, we'll give you a fixed-price treatment package ahead of time, so you always know what you're paying for and don't get any nasty surprises down the line. This includes your aftercare and physiotherapy, as well as any follow-up appointments you need. However, your initial outpatient appointment with your consultant will be charged separately, as will any tests or scans you have at the time to help us make a diagnosis.

Our self-pay patients can take advantage of our flexible payment options, which allow you to spread the cost of treatment over a period of up to five years, with interest-free options available.

If you have private health insurance, spinal surgery will usually be covered by your provider. Speak to your insurer directly to find out.

Compressed spinal nerves

Spine fusion is a common element of spinal decompression surgery, which is performed to reduce pressure on your spinal nerves. This compression might be caused by a slipped disc, a spinal injury, or a condition called spinal stenosis.

Slipped discs

Between our vertebrae we have soft cushions of tissue known as discs, which support flexibility and allow us to bend and twist. A herniated disc, commonly known as a slipped disc, means one of these has moved out of place. One method of treating a slipped disc is to remove it (known as a discectomy) and then fill the gap with a bone graft (spinal fusion).

Spinal instability

Spinal instability is where the connection between two of your vertebrae becomes damaged, allowing for more movement and less strength than usual. This happens most commonly as a result of arthritis and is often treated using fusion surgery.

Deformities of the spine

If you have a deformity in your spine, for example if it curves to the side (known as scoliosis), spinal fusion can help to correct this.

A fractured vertebra

If you have an accident or injury and suffer a fracture to your spine, spinal fusion surgery could be one option to treat it.

Spinal fusion surgery is a major and permanent operation that will only be recommended if your spinal problems can't be fixed using conservative or non-invasive options. These might include a course of physiotherapy, or epidural steroid injections.

Your consultant will start by taking a detailed medical history. They'll ask about your symptoms, how long you've been having them and how they affect your life, as well as whether you've had any treatment to date and how effective it was. Then they will make a physical examination, looking at your spine and typically your lower limbs too. Spinal problems can affect the whole body so this is very common.

Even if you already have a diagnosis from another doctor, our consultants will always want to make their own diagnosis. Our spinal surgeons often send people to our imaging department to get X-rays, CT scans or MRI scans to aid diagnosis. You might be able to have these the same day as your initial consultation, or we might ask you to come back another day. Our hospitals have excellent onsite imaging facilities and our radiologists work closely with our surgeons so that you get your results as soon as possible.

Once we have enough information to make a firm diagnosis, your consultant will start building a treatment plan bespoke to you. This will be based on your personal circumstances and preferences, and they will talk you through all the options, highlighting their own recommendations and explaining why they have chosen them. The final decision about what treatment to have is up to you.

Lumbar or cervical spinal fusion

This relates to the section of your spine being operated on. Your cervical spine is the section that supports your neck. Your lumbar spine is in your lower back.

Anterior, posterior or lateral

There are three ways your surgeon can 'approach' your spine during the operation: from the front (anterior fusion), from the back (posterior fusion), or from the side (lateral fusion).

'Levels' of fusion

You might hear your surgeon refer to how many 'levels' of fusion you are having. This means how many pairs of vertebrae are being fused. So, if one space between two vertebrae is being fused, that would be a one-level fusion. Most fusion surgery involves one or two levels.

Open or minimally invasive

In general, spinal surgery is typically performed as an open procedure, which means that your surgeon opens up your back to access your spine through a large incision (cut). In some instances, it may be possible to us a minimally invasive technique for spinal fusion, known as keyhole surgery. This allows your surgeon to use a smaller incision.

There are benefits to keyhole surgery over open surgery, such as reduced scarring and a faster recovery, however it is not always an option.

You might be asked to stop taking certain medications, which can cause risks during surgery. But unless we tell you to, you can carry on with your usual medications.

Preparing your home for your recovery

Something to remember is that you won't be as active and able as usual when you return home from hospital. It will take you a while to feel back to normal after your surgery.

So, stock up your pantry, fridge and freezer with easy meals and snacks, eliminate tripping hazards so you don't hurt yourself, and ask a friend or relative to check in on your regularly for the first week or two.

Depending on what type of spinal fusion you are having, you will either be lying on your side, your front, or your back.

Your surgeon will begin the procedure by making an incision in order to gain access to your spine. They might also make an additional incision in order to harvest a bone graft (more information below).

Once they have access to your spine, your surgeon may need to perform a procedure such as a discectomy or decompression before they start the fusion. Spinal fusion is often carried out in combination with other procedures, for example as one element of spinal decompression surgery, or alongside a cervical discectomy.

The fusion itself involves filling the gap between two or more of your vertebrae with the bone graft. Your consultant may then use screws, rods or plates to hold the bones in place and encourage fusion. This is called 'internal fixation' or 'instrumentation' and can help promote healing and increase success rates.

Spinal fusion surgery commonly lasts three to four hours and may last even longer depending on the exact details of the operation.

Bone grafting

In order to allow your bones to fuse together, your surgeon will need to use something called a bone graft. This typically consists of small pieces of bone, which are placed in between the vertebrae that need to be fused. In some instances, one or more large pieces will be used to provide rapid structural support.

Bone grafts can either come from your own body (typically from your pelvic bone or a nearby area of your spine) or from a donor. In some instances, your surgeon might use bone substitutes (artificial bones). They will let you know ahead of time which option is best suited to you.

This timeline gives a rough guide to your recovery, but your consultant will be able to give you much more detail and a more accurate picture of what you personally should expect.

Recovering in hospital

When you first wake up, you will probably feel groggy because of the general anaesthetic, and your back may be sore after the operation. Gradually you will start to feel better, and you will usually be encouraged to be up and walking around by the next day.

We'll give you pain medication to manage the post-operative pain, and your physiotherapist will visit you to start your rehabilitation programme.

The typical hospital stay is one to four nights.

Recovering at home

When you're ready to go home, we'll give you all the information you need to look after yourself, including any prescriptions you need such as painkillers. Often people find their pain is managed using over the counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs).

You will need to arrange for a loved one to drive you home as you won't be safe to drive yet. If you would prefer, we can arrange a taxi for you.

You will probably need some help as home for a few days after you get back, as you'll be really tired after the operation and your mobility will be reduced. We also advise that you avoid lifting, awkward twisting and leaning, which can rule out most household tasks. And try not to sit or stand in one position for too long, as it could make your back feel stiff and sore.

Following your physiotherapy exercises as regularly as possible will give you the best chance of a good recovery. Start slow and try to do a little more each day. During this time, you might need to wear a brace, but not everyone does.

If you had non-dissolvable stitches, they will need to be removed five to 10 days after your operation. If this is the case, we will let you know before you leave hospital.

Four to six weeks after surgery

Around four to six weeks after spinal fusion surgery you should start to feel back to normal, though you'll need to take it easy a while longer. Continue to avoid heavy lifting and rigorous exercise and be guided by how you are feeling. You should be able to speak to your physiotherapist and your consultant during this time, and you can ask their advice on what's right for you.

Some people will be ready to drive after two weeks, for others it will take much longer. Speak to your consultant and then with your insurance provider to understand when you'll be ready.

Six to twelve weeks after surgery

By six weeks after surgery, the initial pain and fatigue from your operation should have lifted, and you should be back to normal in some ways. Most people can go back to work, though if you have a manual job or one that involves lots of heavy lifting, you may need to take more time off.

• Blood clots
• Bleeding
• Infection
• Respiratory problems
• Heart attack
• Stroke

Risks specific to spinal fusion include:

• Damage to your spinal nerve
• More pressure on the bones surrounding the fused vertebrae
• Persistent pain

Your consultant will explain all these risks ahead of time, as well as their likelihood in your personal case, so that you are well-informed and reassured before you agree to surgery.

What is spinal fusion?

Spinal fusion is an operation to fuse together two or more of your vertebrae. It is done by adding a bone graft into the space between two vertebrae, which your existing bones then fuse to.

When is spinal fusion necessary?

Spinal fusion surgery is used to treat problems with your spine that make movement painful. If you're having difficult symptoms that might be stopped if your vertebrae didn't move so much, spinal fusion might be recommended.

How long does spinal fusion surgery take?

Typically, spinal fusion surgery lasts 3-4 hours. The time taken will depend on the complexity of your operation.

• Flexible appointment times to fit your schedule
• The freedom to choose your hospital and your consultant
• Bespoke, consultant-led treatment plans tailored to your individual needs
• Private ensuite rooms as standard with tasty and nutritious meals cooked to your dietary requirements
• Support from the same compassionate clinical team from beginning to end
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help spread the cost of your care

If you want to know more about spinal fusion or any other type of spine surgery, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in December 2022. Next review due December 2025.

1. Lumbar decompression surgery what happens, NHS
2. Spinal fusion, OrthoInfo
3. Spinal fusion, Mayo Clinic
4. Lumbar decompression surgery recovery, NHS
5. Types of spinal fusion, Spine Health